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The latest news on Obamacare from Business Insider

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    Bernie Sanders

    Sen. Bernie Sanders says he wants to help President Donald Trump with an overhaul of healthcare, just not one that looks like the GOP's first attempt.

    Asked by CNN's Dana Bash on Sunday about the failure of the American Health Care Act, Sanders said he was planning to introduce his own healthcare bill that included a "Medicare-for-all" feature and would reach out to the president about it.

    "Of course, Obamacare has serious problems: deductibles are too high, premiums are too high, the cost of healthcare is going up at a much faster rate than it should,"Sanders said."Ideally, where we should be going is to join the rest of the industrialized world and guarantee healthcare to all people as a right. That's why I'm going to introduce a Medicare-for-all, single-payer program."

    Trump himself has said multiple times that he wants a healthcare plan to cover "everybody." 

    Sanders also said Trump should "come on board" with the plan.

    Trump told reporters that he was willing to work with Democrats to revamp the healthcare system after the AHCA was pulled fom the House floor because of internal strife in the Republican Party that left leadership's plan to repeal and replace Obamacare short of the votes needed to pass the House.

    Sanders, an independent who caucuses with Democrats and ran for president as a Democrat, also took time to attack the AHCA.

    "The bill that was defeated should have been defeated," Sanders said. "It was a disaster piece of legislation, primarily designed to provide $300 billion to the top 2%, throw 24 million people off health insurance, raising premiums for older workers in a very very significant way. It was defeated, the American people wanted it defeated, and I'm glad we were able to accomplish that."

    The AHCA repealed taxes in Obamacare — officially known as the Affordable Care Act — that primarily fell on the wealthy. The nonpartisan Congressional Budget Office estimated that 24 million fewer Americans would have had health coverage under the AHCA than the current projection, and the AHCA's tax credits were structured in a way that would have caused premiums for low-income and older people to increase significantly.

    SEE ALSO: How 'Trumpcare' went up in flames — and why it should worry the GOP about the future

    Join the conversation about this story »

    NOW WATCH: Animated map shows which states are the biggest winners and losers from 'Trumpcare'


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    doctor smile happy"Trumpcare" is dead, for now, and some healthcare stocks are loving it.

    A number of hospital and healthcare provider companies are seeing an uptick following the inability of Republicans to pass the American Health Care Act — their bill to repeal and replace Obamacare, also called "Trumpcare."

    The thought being that since 24 million more people would have been without insurance under "Trumpcare" compared to the current baseline, fewer Americans would utilize the services of these providers, thus depressing revenues.

    Now after disagreements within the GOP sinking the bill despite the party's majorities in both the House and Senate, and President Donald Trump moving on to other legislative priorities, these companies are in the green despite the broader sell-off in the market.

    Here's a quick rundown of these winners as of 11:45 a.m. ET:

    • Hospital Corporation of America, which manages 168 hospitals and 116 surgery centers, is up 5.1%, and at its highest level since August 2015.
    • Universal Health Services, which manages hospitals and clinics, is higher by 4.1%, and at its best level since November 8, 2016.
    • Tenet Healthcareowner of 470 outpatient facilities and other healthcare service providers, is up 6.9%, and at levels last seen on March 9, 2017.
    • Lifepoint Healtha rural-focused healthcare services provider, is stronger by 2.5%. Its stock hasn't been this high since March 9, 2017.
    • Community Health Systems, owner of 160 hospitals, is up 3.5% and at its best level since October 25, 2016.

    These moves follow solid jumps from the same names as the legislation looked less and less likely to pass on Thursday and Friday. Additionally, all five companies were slammed the day after the election when it seemed Obamacare could be repealed, as Trump promised.

    SEE ALSO: How 'Trumpcare' went up in flames — and why it should worry the GOP about the future

    Join the conversation about this story »

    NOW WATCH: 7 mega-billionaires who made a fortune last year


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  • 03/28/17--08:00: 'Trumpcare' is not dead yet
  • Donald Trump thumbs up

    Just when it seemed over, the Republican attempt to overhaul the US healthcare system made something of a comeback Tuesday morning.

    Republicans emerged from a closed-door caucus meeting saying they had not abandoned their desire to repeal and replace the Affordable Care Act, also known as Obamacare, even after their bill was yanked from the House floor on Friday.

    "On Friday, the votes weren't there yet. That doesn't mean we are not going to get there," House Majority Leader Kevin McCarthy said at a press conference.

    House Majority Whip Steve Scalise added that Democrats' celebrations about the failure of the Republican bill were "premature."

    On Monday, House Speaker Paul Ryan told Republican donors he would continue to work on healthcare reform even after the GOP could not come together on the American Health Care Act, the House GOP leadership's plan that was introduced in early March.

    "I will explain how it all still works, and how we're still moving forward on healthcare with other ideas and plans," Ryan told donors, according to The Washington Post.

    Reports indicated that House Republicans at the conference on Tuesday discussed pushing forward on healthcare reform.

    Associated Press congressional correspondent Erica Werner reported that Republicans leaving the meeting said they were not done, and that Rep. Barry Loudermilk of Georgia said it was only "halftime."

    Rep. Mo Brooks, a member of the hardline conservative House Freedom Caucus and an opponent of the AHCA, said he believed a healthcare plan from Ryan was "fairly immediate,"according to Bloomberg.

    The biggest sticking point for the AHCA was the failure of GOP leadership to persuade members of the Freedom Caucus to agree to the bill. The caucus had demanded a more extreme repeal of Obamacare and had enough votes to block the bill's passage in the House.

    CNN senior congressional producer Deirdre Walsh reported that after the Republican conference meeting, House Freedom Caucus Chairman Rep. Mark Meadows said he still wanted to get healthcare reform done and did not think Republicans should leave for the April recess until legislation has passed.

    The New York Times reported that White House officials, including Vice President Mike Pence and Chief Strategist Steve Bannon, were in talks with the Freedom Caucus and the Tuesday Group, a caucus of more moderate Republicans. According to The Times' Robert Pear and Jeremy Peters, Pence met with Republican representatives on Capitol Hill on Tuesday to discuss healthcare reform.

    It is unclear how House Republicans could agree on a bill, as any concessions to the Freedom Caucus would likely result in the loss of more moderate members of the party. (A nearly equal number of moderates opposed the bill, based on media whip counts.)

    Several Senate Republicans are open to working with Democrats to craft a bipartisan bill to overhaul Obamacare, according to Bloomberg's Steven Dennis, though that effort would appear to be separate from the current House moves.

    SEE ALSO: The next Republican fights could be even worse than its one over healthcare

    Join the conversation about this story »

    NOW WATCH: A reporter asked Spicer if he’s confident that no one in the White House is a foreign agent


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    Paul Ryan Mitch McConnell

    Two leading congressional Republicans had seemingly different views on the future of healthcare overhaul from the party — and whether or not Democrats should be cheering the GOP's inability to bring their to the House floor for a vote last week.

    Rep. Steve Scalise of Louisiana, the Republican House whip, told reporters Tuesday that the celebration from Democrats on the American Health Care Act's failure was coming too early.

    "To my Democrat colleagues who were celebrating Friday's action, I think their celebration was premature because we're closer today to repealing Obamacare than we've ever been before. Surely, even closer than we even were Friday," Scalise said at a press conference held by House Republican leaders.

    Slightly less optimistic was Senate Majority Leader Mitch McConnell, who told reporters on Tuesday that Obamacare was going to stick around.

    "I think where we are on Obamacare, regretfully, is where Democrats wanted us to be — with the status quo,"he said. 

    He continued that he expected Democrats to be pleased about the AHCA's failure.

    "Well it's pretty obvious we were not able, in the House, to pass a replacement," McConnell said. "Our Democrat friends out to be pretty happy about that because we have the existing law in place."

    For their part, Democrats did gloat after the GOP could not muster enough votes to pass the AHCA, which became colloquially known as "Trumpcare," through the House. Disagreements between the conservative and moderate wings of the party, plus House Speaker Paul Ryan and President Donald Trump's inability to bring the sides together, led to the bill being pulled from the House floor.

    House Minority Leader Nancy Pelosi said on Friday that the decision to pull the bill by Trump and Ryan was "a victory for the American people."

    SEE ALSO: 'Trumpcare' is not dead yet

    Join the conversation about this story »

    NOW WATCH: Watch Trump surprise the first White House tour group


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    donald trump

    President Donald Trump's popularity may have taken a hit from the Republican failure to overhaul the US healthcare system.

    A Morning Consult/Politico poll released Wednesday showed Trump's popularity underwater for the first time in the recurring survey. Overall, 50% of respondents said they disapproved of the job Trump was doing, while 45% approved.

    When it came to the American Health Care Act, the GOP bill to repeal and replace Obamacare, the numbers were just as lackluster for Trump.

    The AHCA was pulled from a House vote Friday after both conservative and moderate members of the GOP came out against the bill. House Speaker Paul Ryan and Trump were unable to bring enough of the holdouts on board to ensure the bill would be passed, despite the large Republican majority in the House.

    Twenty-two percent of those surveyed said Trump was most responsible for the failure of the AHCA, while 24% said it was Republicans in the House. Just 10% said it was primarily the fault of Ryan. Democrats in the House were blamed by 22% of those surveyed.

    Those in the poll who identified as Democrats or as independent were most likely to blame Trump primarily, while Republicans blamed Democrats in House.

    Forty-six percent of respondents said that if Republicans did not repeal and replace Obamacare by the 2018 midterm elections, the party would lose its majority in either one or both chambers of Congress, while 21% thought it would retain both.

    But 51% of those polled thought Republicans should move on from the AHCA and focus on other agenda items, while 37% said the GOP should continue in its efforts.

    Additionally, 50% of those surveyed in the Morning Consult/Politico poll said they approved of Obamacare, while 43% disapproved. This follows a recent trend in polls showing the law, officially known as the Affordable Care Act, hitting its highest popularity since its passage in 2010.

    The new data comes after a series of polls showing the AHCA, also known as Trumpcare, to be seriously unpopular.

    In the week before the vote on the bill, an aggregate of polls from FiveThirtyEight showed 30% of Americans approved of the bill, while 47% disapproved. On Thursday, a Quinnipiac poll even registered the bill's approval rating at just 17%.

    Trump's popularity has also been sliding. Before Wednesday's Morning Consult/Politico poll, Gallup's approval rating, updated Monday, dipped to its lowest point in Trump's young presidency. As of Wednesday, FiveThirtyEight's aggregate of polls showed 41.6% of people approved of Trump's job performance, while 52.4% disapproved. The aggregate on the day the AHCA was introduced earlier this month displayed approval of 43.9% versus disapproval of 49.7%.

    SEE ALSO: Trump is making huge changes to his economic plans after the 'Trumpcare' defeat

    Join the conversation about this story »

    NOW WATCH: A reporter asked Spicer if he’s confident that no one in the White House is a foreign agent


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    Donald Trump Tom Price

    President Donald Trump's administration wants to make clear it is doing "everything in our power" to dismantle the Affordable Care Act, the law known as Obamacare.

    A new web page from the Department of Health and Human Services touts the Trump administration's efforts to undermine the law.

    The page, entitled "Providing Relief Right Now for Patients," goes through various regulatory changes being implemented at HHS to the ACA and its programs.

    "A functioning, competitive market for health insurance is a crucial element of providing patients access to quality, affordable care,"the page reads."But with skyrocketing premiums and narrowing choices, the Affordable Care Act (ACA) has done damage to this market and created great burdens for many Americans."

    The page includes links to stories announcing various changes the administration has made so far in an attempt to "to stabilize the individual and small group insurance markets."

    "We are going through every page of regulations and guidance related to the Affordable Care Act to determine whether or not they work for patients and whether or not they are making our health care system better," reads the page.

    While this is the most public forum for Trump's attempts to alter the ACA, the administration has previously pulled advertising for the last two weeks of open enrollment on Obamacare's insurance exchanges, which contributed to a decline in sign-ups.

    HHS and the Centers for Medicare and Medicaid Services also released new reforms for the individual marketplaces in February. They included cutting the length of open enrollment in half and taking steps to make more difficult the process of signing up for Obamacare plans outside of open enrollment.

    Trump has repeatedly said that Obamacare is "collapsing," House Speaker Paul Ryan called the plan to repeal and replace Obamacare an "act of mercy," and many Republicans have said the law is in a "death spiral."

    Health policy analysts, however, have argued that enrollment — even with the changes after Trump's inauguration — has stayed strong and does not meet the criteria for a "death spiral."

    Trump, Ryan, and Republican leaders failed to wrangle enough votes last week to pass their preferred replacement for Obamacare, the American Health Care Act.

    SEE ALSO: Trump's approval ratings crater even further after 'Trumpcare' debacle

    Join the conversation about this story »

    NOW WATCH: Obama's White House photographer has been trolling Trump on Instagram


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    paul ryan

    House Republicans, still reeling from an embarrassing failure to bring their healthcare bill to a floor vote last week, are considering another attempt to pass the legislation. 

    According to Billy House and Sahil Kapur of Bloomberg, House GOP leaders could bring back the American Health Care Act as early as next week for a vote on the House floor.

    Citing two Republican lawmakers, Bloomberg reported a deal is being ironed out between the hardline conservatives in the House Freedom Caucus and more moderate GOP members to make the AHCA more palatable for both sides.

    It is unclear whether the move would come in the form of a new bill or an amended version of the AHCA.

    AshLee Strong, a spokesperson for House Speaker Paul Ryan, told Business Insider there was "no schedule update" on any Obamacare replacement bill, throwing cold water on the possibility of a vote in the coming days.

    "The speaker has encouraged members to continue talking so we can get to a place of yes and fulfill our promise to repeal and replace Obamacare," Strong said.

    The AHCA, which would repeal and replace Obamacare, was pulled from the House floor minutes before a vote was set to be held Friday. Members of the Freedom Caucus felt the bill did not go far enough in its repeal of Obamacare, while moderates expressed concern about the large coverage losses forecast under the AHCA.

    House GOP leaders seemed optimistic that the AHCA could be revived during a press conference Tuesday, and Ryan told Republican donors on Monday that the conference was "still moving forward on healthcare."

    But until Wednesday, no timeline had been floated for such a revival. The AHCA, which was pulled from a floor vote just 18 days after it was introduced, was fraught with deadlines that to many lawmakers seemed arbitrary and complicated its legislative process.

    Bloomberg cited numerous GOP House lawmakers saying that discussions were ongoing, but they were not sure when the bill was going to be set to be reintroduced.

    Reports indicated that the White House was also involved in the negotiations. According to the New York Times, Vice President Mike Pence met with Republican House members on Tuesday, and chief strategist Steve Bannon was also trying to win over skeptical members.

    A spokesperson for the House Freedom Caucus didn't immediately respond to requests for comment.

    Check out the full report at Bloomberg»

    SEE ALSO: Trump's approval ratings crater even further after 'Trumpcare' debacle

    Join the conversation about this story »

    NOW WATCH: A hacker explains why Trump using his old Android phone for Twitter could be a huge security threat


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    Paul RyanCongressional Republicans’ failure to bring their healthcare bill to the House floor for a vote last week has set off a renewed push to expand one of the Affordable Care Act's most popular provisions — an expansion of Medicaid, the government-run health program that provides insurance primarily to pregnant women, single parents, people with disabilities, and seniors with low incomes.

    Obamacare expanded eligibility for Medicaid to include any adult living under 138% of the federal poverty level — an income of $27,821 for a family of three in 2016.

    Thirty-two states, including the District of Columbia, have chosen to participate, leading to more than 11 million people nationwide gaining coverage.

    The American Health Care Act, the GOP’s leadership's bill, would have rolled back the expansion by cutting roughly $880 billion in funding to the program and enacting changes to eligibility that would have led to a loss of 14 million people from the Medicaid rolls by 2026, according to a Congressional Budget Office report.

    But the apparent demise of the AHCA has meant that Obamacare and its Medicaid expansion, in the words of House Speaker Paul Ryan said last week, remains "the law of the land" for the "foreseeable future."

    That has produced renewed vigor for expansion in Virginia and North Carolina, where Democratic governors have announced plans to to try to push Medicaid either through executive action or legislatures. In Maine, the secretary of state's office certified more than 66,000 signatures collected for an initiative to expand Medicaid. It will be voted on by the public in November.

    But the state currently closest to expanding Medicaid is Kansas, which sent a bipartisan bill to Republican Gov. Sam Brownback on Tuesday and now awaits a signature or veto from the staunch conservative. It is unclear which option he will choose.

    While the bill has been in the works for several years, the AHCA's failure has stepped up the urgency, Kansas legislators and interest groups told Business Insider.   

    "We can’t be sitting on our hands waiting for the federal government to act. Like the president said, healthcare is complicated," Denise Wyzman, the executive director for the Kansas Association for the Medically Underserved, an association of primary care clinics and health centers in the state, told Business Insider.

    She added: "We need to do what’s right for Kansas now."

    'The public screamed at us'

    brownback sam kansas

    The Kansas bid to expand Medicaid, House Bill 2044, only became viable earlier this year. While Kansas remains a deep-red state, conservative Republican legislators were ousted by a wave of moderate primary challengers in the 2016 election as the state's economy has deteriorated under Brownback's governorship.

    KanCare, the state’s Medicaid program, currently covers approximately 375,000 people in the state. Estimates have said that around 150,000 additional Kansans would be extended coverage under the expansion plan.

    Moderate Republican challengers were able to win in 2016 because Kansas voters were upset by Brownback’s tax policies, the financial situation of the state, and stalled efforts to expand Medicaid, Sen. John Doll, one of those moderate Republicans to win a seat in 2016, told Business Insider.

    "We’re always going to be a red state, but the public screamed at us about our tax policies and measures like this Medicaid expansion," Doll said.

    Shortly after the new year, the newly moderate-leaning Kansas House introduced the Medicaid bill, where it stalled for a time in committees before roaring back in late February, passing by a margin of 81-44. It was introduced in the Senate shortly after, passing on Tuesday by a margin of 25-14.

    "There was enough of a swing that not only was this the first time we were able to introduce a bill like this, we were able to pass it," Barbara Bollier, a first-term senator representing several Kansas City suburbs and a retired physician, told Business Insider.

    Doll, who represents primarily rural district in Western Kansas and previously served in the House for four years, said public opinion in his district is solidly behind the Medicaid expansion. Phone calls, emails, and in-person conversations in his office have shown overwhelming support for the bill.

    A public opinion poll conducted by the American Cancer Society in January found that 82% of Kansans support the Medicaid expansion. Several other polls from this year and year's past put the number closer to 62%. Still, it has been hampered, its supporters say, by its association with the Affordable Care Act.

    "Some of us can’t get past the origination of the law," Dolls said. "We’ve got to look past parties and look at policies. We need a big lesson that at every level of government, but especially state and federal. We need to look at what’s good for the people."

    A 'net-win'

    BI Graphics_Medicaid Expansion

    The bill has received widespread support from nearly every corner of the healthcare industry in the state. During Senate debate on the bill, nearly 200 pieces of testimony were submitted from healthcare providers, hospitals, physicians, and patients.

    Bollier said the Medicaid expansion would be a "net-win" for not only the 150,000 Kansans due to gain coverage, but also for the state as a whole. The healthcare sector would see a large economic boost, Bollier said, predicting the creation of new jobs in the industry as well as in secondary industries affected by the influx of federal funds.

    A recent study published by the Kansas Hospital Association, a supporter of the bill, found that Kansas has 31 hospitals"vulnerable" to closure, many of which are major employers in rural areas. Expansion could be crucial to ensuring that they are able to stay afloat, Cindy Samuelson, the organization's vice president, told Business Insider.

    Cyzman, the director of KAMU, said primary-care clinics and health centers are clamoring for the expansion because they already treat 14% of Medicaid enrollees in addition to providing $41 million in care to struggling populations that is never compensated. Cyzman said conservative estimates suggest expansion would bring anywhere from $9 million to 15 million back to clinics in reimbursements, which could then be used to provide even more care.

    "All of these people will have access to screenings, tests, better-priced medications, and all of the things that the rest of the country has been able to access through healthcare and insurance," Bollier said. "Bottom line: social justice will be served."

    A win-win?

    lawrence, kansas

    One of the main obstacles to the bill’s passage among many Senate Republicans in the state was the uncertainty surrounding the possible federal healthcare overhaul.

    One senator, Ty Masterson, likened expanding Medicaid to asking to get on an "amusement park ride that's closed" and "broken." Others have echoed his sentiments.

    But the AHCA's failure last week "made it easier" for many senators to vote for the bill, Doll said, because it made clear that an Obamacare repeal could take a long time, if it happens at all.

    The bill itself was written with congressional Republicans’ repeal efforts in mind. It includes several "poison pill" provisions. One stipulates that if the percentage of federal matching funds for Medicaid drops below its current level of 90%, as the AHCA proposed, the expanded program in Kansas would be eliminated, Samuelson said.

    "We have nothing to lose by moving forward and everything to gain," said David Jordan, the executive director of the Alliance for a Healthy Kansas, a grassroots coalition of more than 100 interest groups spanning healthcare, Chambers of Commerce, and city councils.

    "We will gain hundreds of millions of dollars a year that can make a profound impact not just on uninsured Kansans, but protecting hospitals and jobs in these at-risk communities," he told Business Insider.

    Many, including Samuelson, have said possible ACA repeal has made Medicaid expansion even more urgent for the state. Current congressional Medicaid proposals would change the federal funding to a per-capita spending cap, meaning the federal government would send states a fixed amount of money per Medicaid enrollee. States that expanded Medicaid, and therefore have much larger enrolled populations, would receive more federal funds under such a program.

    "We want to put Kansans in the best position," Samuelson said. "By being able to expand our population, that puts us in a more comparable place as other states that have expanded."

    And if an Obamacare replacement bill isn’t passed for months or years, Kansas would still benefit from the influx of federal funds, advocates say.

    Still, some in the legislature, like Senate president Susan Wagle, a Republican, say expanding the program ties Kansas to "the whims of the federal government." 

    The federal government "would be an unpredictable and unreliable partner" in healthcare, Wagle told the Associated Press, adding that the cost of the program could eventually be forced onto the state, which is currently suffering a budget deficit. 

    'You can't let perfect be the enemy of good'

    wichita kansas

    Under Brownback’s direction, Kansas privatized KanCare in 2012, trimming the program and shifting to managed care organizations, according to The Wichita Eagle.

    Federal investigators from the Centers for Medicare and Medicaid Services slammed the program shortly before Trump took office, calling it "substantively out of compliance with federal statutes and regulations, as well as its Medicaid State Plan."

    CMS said in its January letter to the state that it had received complaints from beneficiaries, healthcare providers, and advocates throughout 2016 on KanCare’s plans enrollees and its communication with the public. The Obama administration rejected the state’s request to extend its privatized program past this year, citing the issues, though the Trump administration could reverse course in the coming months.

    While Bollier acknowledged that there are issues with the current administration of KanCare, she said legislators are working to rectify issues in the system and that voting no on the expansion bill with that rationale a "pretty lame excuse."

    "We have hundreds of thousands of people covered currently," Bollier said. "Is Medicaid perfect? No. But it’s the best we have in our current circumstances. You can’t let perfect be the enemy of good."

    Doll suggested the KanCare issues CMS highlighted may have swayed some legislators on the fence to vote for expansion, if only to get more funds to the program.

    Anybody's guess what happens next

    Though Brownback said in 2014 that he would leave it to the legislature to decide whether to expand Medicaid or not, recent statements by his office indicate the governor may not sign the bill. They have cited developments in Obamacare over the past few years.

    "To expand Obamacare when the program is in a death spiral is not responsible policy," Brownback spokeswoman Melika Willoughby said in a statement Monday. "Kansas must prioritize the care and service of vulnerable Kansans, addressing their health care needs in a sustainable way, not expanding a failing entitlement program to able-bodied adults."

    Both Doll and Bollier are not optimistic about Brownback changing his mind, but Bollier has said an override vote in the legislature is possible. The bill would need an additional three yes votes in the House and an additional two in the Senate to override the governor’s veto. A preliminary vote on the bill in the House reached that threshold, though the Senate never did.

    "None of us can predict what [Brownback] is going to do," Bollier said.

    Gaining the votes for an override, he added, "would be a monumental task, but that doesn’t mean it’s not possible."

    SEE ALSO: A big part of the GOP's Obamacare replacement may accomplish the opposite of its goal

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    NOW WATCH: People on Twitter are turning Paul Ryan’s healthcare presentation into hilarious memes


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    Thomas Tom Massie

    BUCKNER, Kentucky — One of the House Republican rebels, Rep. Tom Massie of Kentucky, wasn't just "no" on the GOP healthcare bill to replace Barack Obama's Affordable Care Act. Massie was "hell no."

    That won over Mary Broecker, the president of the Oldham County Republican Women's Club who is a strong proponent of a full-blown repeal of the 2010 law.

    "When he came out against this bill, I thought, 'I trust him so this must be the right way,'" the 76-year-old retired teacher said of Massie this week as she sat at a coffee shop near her LaGrange home.

    Defying President Donald Trump on the seven-year Republican Party promise to repeal and replace "Obamacare" sounds like political suicide, especially in the congressional districts Trump won handily. Yet in Kentucky, North Carolina, Tennessee, and Iowa in the bitter aftermath of the GOP's epic failure, Republicans who blocked the legislation have won praise from constituents for stopping what many saw as a flawed plan, either in the legislation's substance or in its strategy.

    In the House, hard-line conservatives opposed the bill because it didn't go far enough in getting the government out of healthcare while moderates worried that tens of millions of Americans might be left without insurance. Trump's famed dealmaking and power of persuasion faltered with his own party, a remarkable turn at a time when the GOP controls the White House, the Senate, and the House.

    Nationwide, an Associated Press-NORC Center for Public Affairs Research poll released Wednesday found that 62% disapproved of the way Trump was handling healthcare, his worst rating among seven issues the poll tested, including the economy, foreign policy, and immigration.

    The same poll found negative views of five of the six changes Republicans envisioned for the bill, including allowing insurers to charge older customers higher premiums than is now allowed, reduced funds for Medicaid, and denying federal dollars to Planned Parenthood.

    Yet the same voters who backed their local lawmaker for opposing the bill showed patience with Trump.

    "I think he's going to be a great president," Broecker said. "I think he'll figure it out."

    In the districts of the bill's foes, Republican voters and activists faulted Republican House Speaker Paul Ryan of Wisconsin. Some argue he was too willing to accept pieces of Obamacare.

    "We've been hearing 'repeal and replace' for seven years and finally we get control, and they say, let's just kind of fix it," said 31-year-old Justin Wasson of Cedar Rapids, Iowa, who runs a small business. "We gave them everything. Now, I want this thing gutted."

    Shea Cox, a 21-year-old computer science major from Shelbyville, Tennessee, said the bill failed because Ryan rushed what Cox called a "complete hack job" that "looked almost exactly like "Obamacare" with a couple of things taken out." That's why he was happy to see Tennessee Rep. Scott DesJarlais oppose it.

    Paul Ryan Donald Trump

    With midterm elections coming next year, Wasson said he planned to vote again for his congressman, Rep. Rod Blum of Dubuque — a sentiment echoed by other voters whose representatives opposed the bill.

    Gary French, a minister from Buckner in Massie's district, said it was a "piecemeal" bill and his representative was right in opposing it. "The issue's not dead — they'll return to it," he said. "Absolutely. I think they're going to have to do what the constituents want."

    Kelly Stanger of Lowell, Michigan, argued that conservatives were prevented from contributing to the bill, and she said she'd vote again for Rep. Justin Amash, who opposed it.

    "He has no problem taking heat," the 50-year-old cafe waitress said. "I don't think just because you belong to a party that you have to agree."

    She said she voted for Trump because "there needed to be change," adding, "It's not going to be easy."

    The failure of the health bill in the House may have spared a couple of GOP senators a tough vote as the legislation grew increasingly unpopular with the public. The two most vulnerable GOP senators in next year's midterms, Dean Heller of Nevada and Jeff Flake of Arizona, represent states with large populations of older voters who would have been disproportionately affected by higher premiums under the bill.

    Senate Majority Leader Mitch McConnell of Kentucky, far from dwelling on the bill's defeat or weighing plans to revive it, quickly moved on to other issues. The House bill had already divided GOP senators and would have required major changes to pass.

    A leading opponent was Rep. Mark Meadows, the head of the hard-right Freedom Caucus. In Meadows' North Carolina district, 77-year-old Hendersonville retiree Don Lee said he voted for Trump to "bring Republicans together," but he added that the president "needed to take some more time with this bill and try to find some unity."

    House members, not Trump, need to prove commitment to the issue, said Cedar Rapids Republican Brett Mason, who wishes Blum would have backed the bill.

    "The president went up to Capitol Hill on this," the 58-year-old information technology strategist said. "The onus is now on them to frame up a bill and put it on his desk."

    ___

    Beaumont reported from Des Moines, Iowa. AP reporters Sheila Burke in Shelbyville, Tennessee, Chris Ehrmann in Ionia, Michigan, Jeffrey Collins in Hendersonville, North Carolina, and Erica Werner in Washington contributed to this report.

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    Paul Ryan

    House Speaker Paul Ryan on Thursday suggested he was wary of a bipartisan approach to healthcare.

    In an interview with CBS "This Morning,"Ryan said he was concerned that if the House Republican conference didn't get a healthcare bill passed, President Donald Trump would move on and work with Democrats.

    "What I worry about Norah is that if we don't do this, then he'll just go work with Democrats to try and change Obamacare, and that's hardly a conservative thing,"Ryan told CBS.

    "This is a can-do president, who's a business guy, and he wants to get things done. I know he wants to get things done with the Republican Congress, but if this Republican Congress allows the perfect to be the enemy of the good, I worry we'll push the president into working with the Democrats. He's been suggesting that as much."

    Ryan also told reporter Norah O'Donnell that he and Democratic House Minority Leader Nancy Pelosi "see things very differently" and that he has not reached out to get bipartisan support for the American Health Care Act, the legislation Ryan pulled from what looked to be a failed floor vote last week.

    Trump told reporters Friday after the defeat of the AHCA that the bill did not have any Democratic support. Since, he has suggested that going forward, a bipartisan approach may be the best way to get a healthcare plan through Congress.

    Ryan also told CBS that despite the initial failure of the AHCA, Republicans still want to repeal and replace Obamacare.

    "About 90% of our members are for this bill, and we're not going to give up after seven years of dealing with this, after running on a plan all of last year, translating that plan into legislation, which is what this is,"Ryan said.

    The AHCA was introduced earlier this month, and the GOP had no cohesive plan to replace Obamacare previously, though Ryan, Trump, and numerous other Republicans had put forth rough proposals.

    The AHCA ran into intraparty division among GOP House members, as conservative lawmakers in the House Freedom Caucus felt the bill did not go far enough, while moderate Republicans balked at the changes to Medicaid funding and the possibility of large insurance coverage losses for Americans.

    Ryan said the leadership is still focused on addressing those issues, with input from the Republican conference.

    "We're listening to people and if we can make improvements to this bill, all the better," Ryan said. "If improvements can be made to this legislation that get people to yes, that's great."

    Watch the interview at CBS »

    SEE ALSO: House Republicans might take another swing at repealing Obamacare

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    Republican Governor Sam Brownback of Kansas, speaks during the Conservative Political Action Conference (CPAC) in National Harbor, Maryland, U.S., February 23, 2017.      REUTERS/Joshua Roberts

    Kansas Gov. Sam Brownback vetoed a bill Thursday that proposed expanding Medicaid, the government-run health program that provides insurance primarily to pregnant women, single parents, people with disabilities, and seniors with low incomes.

    "I am vetoing this expansion of Obamacare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs," Brownback said in a statement.

    Lawmakers have been trying to expand the program under a provision of the Affordable Care Act that opens eligibility up to any adult living under 138% of the federal poverty level — an income of $27,821 for a family of three in 2016.

    Thirty-two states, including the District of Columbia, have chosen to participate, leading to more than 11 million people nationwide gaining coverage.

    In Kansas, the bill's supporters, a bipartisan coalition of moderate Republicans and the state's Democrats, are expected to attempt to override Brownback's veto. The Kansas House passed the bill in February by a margin of 81-44 and the Senate passed it on Tuesday by a margin of 25-14.

    In order to override Brownback's veto, the legislature would be need an additional three votes in the House and an additional two votes in the Senate, which many of the bill's supporters have acknowledged would be a tall order. 

    Sen. John Doll, a moderate Republican elected in 2016 amidst a public backlash against Brownback's conservative policies, told Business Insider on Thursday that it is likely the House will override, but garnering the two votes needed to override in the Senate will very "really difficult."

    "I hope we are able to. I just don’t see it," Doll said. 

    Barbara Bollier, a first-term senator representing several Kansas City suburbs and a retired physician, said that overwhelming public support for the bill could push some senators and representatives from no to yes. 

    A public opinion poll conducted by the American Cancer Society in January found that 82% of Kansans support the Medicaid expansion. Several other polls from recent months put the number closer to 62%. Still, it has been hampered, its supporters say, by its association with the Affordable Care Act.

    Bollier specifically said that Senate President Susan Wagle, who represents an area of central Kansas including Wichita, Kansas's largest city, will be pushed by the bill's supporters and Kansans because she is the most high-profile "no" vote.

    A major supporter of the bill, Doll said that even if an override fails, public support ensures that Medicaid expansion will be raised by lawmakers again, though probably not until the next legislative session.

    "It will come before the legislature again and again until it becomes law. Or until [the ACA] is repealed in Washington," Doll said.

    A major obstacle to the bill's passage is its association with the ACA, according to Doll.

    "Some of us can’t get past the origination of the law," Doll said. "We’ve got to look past parties and look at policies. We need a big lesson that at every level of government, but especially state and federal. We need to look at what’s good for the people."

    In his veto memo, Brownback said that an increase in federal Medicaid funding would result in increased funding to abortion providers such as Planned Parenthood and said that because Kansas is "pro-life," he could not support the bill.

    Bollier called Brownback's reasoning "disingenuous" and a "weak excuse," noting that amendments to the Medicaid expansion bill addressing funding to abortion providers were introduced in both chambers and were voted down because voters did not support the measures. 

    "The people have spoken. [Planned Parenthood is] not their issue," said Bollier. "We're a far cry from listening to the people right now."

    Bollier also suggested that Brownback's objection to the bill's lack of work requirements for Medicaid reciepents was a non-issue because the population gaining coverage is "the working poor."

    Check out our deep dive into the battle over the bill in Kansas here»

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    Anthem Blue Cross

    Anthem is the latest major insurer to voice its displeasure with the uncertainty and political gamesmanship roiling the Affordable Care Act markets, and is now sending signals that it may pull out of the system next year.

    If Anthem and its Blue Cross-Blue Shield affiliates do in fact pull back in 2018, as Jefferies analysts David Windley and David Styblo said is “likely” to happen in a note on Thursday, it would leave more than 800,000 individual plan customers in 14 states either without subsidized Obamacare coverage or more limited choices.

    About 255,000 people throughout Colorado, Kentucky, Missouri and Ohio would have no Obamacare insurers beginning in 2018 if Anthem were to pull out, according to a recent analysis by Axios. Meanwhile, 560,000 people in eight other states would have just one insurer to turn to.

    Anthem was noncommittal in reacting to the report of its imminent departure from the market. According to Reuters, the analysts said that, based on conversations with the company, “Anthem is leaning toward exiting a ‘high percentage’ of the 144 rating regions in which it currently participates.”

    The company said in a statement, “We continue to actively pursue policy changes that will help with market stabilization and achieve the common goal of making quality health care more affordable and accessible for all.”

     Reading between the lines, the company’s message seems to be that unless Washington gets its act together on health care, Anthem will join other insurance giants like UnitedHealth Group, Cigna, Humana and Aetna in pulling out of Obamacare markets in many regions of the country.

    It’s an axiom of the health care industry that insurance companies need certainty and relative tranquility in the marketplace to effectively map out a strategy and set premium levels for the coming year if they are expected to stick with the program.

    Instead, insurers and health care providers have been thrust into a crisis atmosphere in the wake of the collapse of the GOP Obamacare replacement legislation in the House last week.  Since then, Trump and House Speaker Paul Ryan (R-WI) have been giving conflicting signals on what if anything will be done to try to recoup their losses and eventually push through changes.

    Meanwhile, since shortly after Trump took office, the new administration has been pursuing a series of administrative actions to try to undermine Obamacare, in an apparent effort to lend credence to the Republicans’ assertion that the health care law is in a “death spiral” of soaring premiums and shrinking coverage.

    One way Trump administration could effectively torpedo Obamacare is by killing off a $7 billion a year out-of-pocket cost-sharing subsidy for insurers and moderate and middle-income people. The subsidies, considered essential by consumers and insurance companies in order to keep insurance costs affordable, are projected to rise to $10 billion next year.

    The provision has suffered a serious setback in federal court. If Trump and Health and Human Services secretary Tom Price decide to drop an appeal by the Obama administration of the adverse ruling, then the subsidy likely would go down the drain – with dire consequences for the future of Obamacare.

    Ryan optimistically told reporters on Thursday that Trump could keep the subsidies alive while the case works its way through the courts. “While the lawsuit is being litigated, then the administration funds these benefits,” Ryan said, “That’s how they’ve been doing it, and I don’t see any change in that.”

    But Ryan’s assurances apparently weren’t good enough for many insurance executives, according to a quick survey of the industry by Axios. Many executives said they want a pledge from Trump that the subsidies will continue before the commit to another season with Obamacare.

    “Speaker Ryan’s comments are encouraging but not clear enough for companies to make solid business decisions,” said Ceci Connolly, the CEO of the Alliance of Community Health Plans, a not-for-profit network. “If the House maintains its lawsuit and the Trump administration drops the appeal, millions of working families will lose those vital subsidies.”

    SEE ALSO: Some huge insurers are also skeptical of the GOP's Obamacare replacement

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    donald trump

    Just a few days after his first major legislative defeat, President Donald Trump told a bipartisan crowd of senators at a White House dinner  Tuesday night that he could turn it around fairly quickly.

    "I know that we are going to make a deal on healthcare. That's such an easy one,"Trump said."I have no doubt that that's going to happen quickly."

    It was a comment Trump's press secretary later said was made in jest, alluding to remarks he made during the healthcare debate about its complications. 

    But this week, despite the American Health Care Act's failure one week ago, Trump and other Republican leaders have suggested that they have not given up on their vow to repeal and replace Obamacare.

    And they're doing so in earnest.

    A House divided

    House Majority Whip Steve Scalise came to the podium Tuesday and warned Democrats about celebrating the failure of the AHCA.

    "To my Democrat colleagues who were celebrating Friday's action, I think their celebration was premature because we're closer today to repealing Obamacare than we've ever been before. Surely, even closer than we even were Friday," Scalise said.

    Along with Scalise, House Speaker Paul Ryan, House Majority Leader Kevin McCarthy, and the rest of the GOP leadership seemed to keep the possibility that the AHCA could be revived. But the chamber remains deeply divided — perhaps even more so than last week, when leadership could not wrangle enough votes to pass the legislation. 

    paul ryan

    A mood of optimism continued, however, as Bloomberg reported that the GOP leadership was mulling bringing the healthcare bill back to the floor of the chamber as soon as next week, citing two anonymous Republican lawmakers. Numerous reports also indicated that GOP members outside of the leadership were itching to get back to work on the healthcare bill.

    "If we just sit up here and play tiddlywinks, it’ll hurt us," Rep. Morgan Griffith of Virginia told Bloomberg.

    But a spokesperson for Ryan told Business Insider on Wednesday there was "no schedule update" for a possible vote on the legislation. And there seems to be a big reason for this strong, but noncommittal, talk: the same divisons that sank the AHCA the first time around haven't gone anywhere.

    According to most media counts, roughly 33 to 35 House GOP lawmakers had come out publicly against the AHCA. Republicans can only withstand 21 defections for the bill to pass.

    And the formation of two distinct ideological groups has made it near impossible to see how the current form of the AHCA could make it through a House vote.

    mark MeadowsOn one side, there is the hardline conservative House Freedom Caucus. Despite the Caucus' chairman Rep. Mark Meadows of North Carolina insisting that members of their conference are "working to get to 'yes'" on the AHCA, members of the group have maintained their stance that the AHCA does not far enough in repealing Obamacare.

    On the other, members of the moderate Tuesday Group have taken issue with the changes to Medicaid funding under the AHCA that would likely see the government program that provides insurance to low-income Americans get cut in many states. The Congressional Budget Office's projections that 24 million fewer people could be covered over the next 10 years under "Trumpcare" compared the current system also raised red flags.

    The two groups attempted to get together and work out their differences on Wednesday — but according to Axios' Jonathan Swan, it did not go well.

    A Tuesday Group source told Axios that "fireworks" erupted at the Tuesday Group's meeting on healthcare. Additionally, a meeting of the Freedom Caucus, Tuesday Group, and the conservative Republican Study Committee, but it was called off.

    Ryan, in an interview on Thursday with CBS News, said Republicans needed to get a repeal-and-replace bill done before Trump shifted and began to work with Democrats on solutions for the existing ACA.

    "What I worry about, Norah, is that if we don't do this, then he'll just go work with Democrats to try and change Obamacare, and that's hardly a conservative thing," Ryan told CBS News reporter Norah O'Donnell.

    The Senate moves on

    Senate Majority Leader Mitch McConnell came to the podium and gave Democrats permission to be pleased about the failure of the AHCA.

    "It's pretty obvious we were not able, in the House, to pass a replacement," McConnell said on Tuesday shortly after the press conference given by the GOP House leaders. "Our Democratic friends ought to be pretty happy about that because we have the existing law in place, and I think we're just going to have to see how that works out," McConnell said. "We believe it will not work out well, but we'll see."

    Most the action on the AHCA has been focused in the House — it was there the bill was written and failed to pass — but it the Senate could be an even bigger hurdle for the bill, complicating any future efforts to pass the legislation.

    Many GOP senators this past week have begun discussing working on a bipartisan solution for healthcare.

    Republicans attempted to use the budget reconciliation process, since Democrats could filibuster any substantial change to the law, meaning they would only need a 50-vote majority to get the bill passed in the Senate. With that off the table, some leading GOP senators have decided that finding common ground and getting over the 60-vote threshold would be the best option.

    "The most constructive thing would be for there to be a bipartisan proposal that would stabilize the market for the next three years while we create long-term solutions to the Affordable Care Act," Sen. Lamar Alexander of Tennessee said on Tuesday.

    Alexander and Sen. Bob Corker, also a Republican from Tennessee, introduced a bill on Wednesday that would take the existing ACA framework and provide stabilization to the individual insurance market — rather than totally repeal the law.

    Sen. John Cornyn of Texas has offered similar sentiments, inviting Democrats to the table to fix the deficiencies of Obamacare.

    "I think that’s the lesson of last week — that it needs to be done on a bipartisan basis, and so we’re happy to work on it with Democrats if we can find any who are willing to do so rather than those who just want to stand back and enjoy the show," Cornyn said Monday.

    senator lamar alexander skeptical elected government official GettyImages 631926798

    Many Senate Republicans detested the AHCA in the first place.

    Sen. Tom Cotton of Arkansas, an ardent Trump supporter in the election, repeatedly took a hatchet to the healthcare bill and became a loud, leading voice in opposition.

    "To my friends in House: pause, start over. Get it right, don't get it fast,"Cotton said on March 9.

    Cotton also blasted the supposed three-step process that the White House and House GOP touted for its repeal and replace of Obamacare, calling it "just politicians engaging in spin."

    The White House is muddled

    Trump, for his part, hasn't helped heal the divisions while talking up the possibility of completing a new deal, blasting fellow Republican lawmakers who helped sink the legislation and making a questionable endorsement of a Ryan critic. 

    Donald TrumpAfter first directing most of the blame at Democrats, Trump muddied the waters when he tweeted that people should watch Judge Jeanine Pirro's show on Fox News. It included an extended tirade calling for Ryan to step down and blamed him for the AHCA's failure.

    Ryan told CBS News that Trump was "apologetic" about the tweet and did not know Pirro was going to attack the speaker.

    But Trump spent most of his week homed in on the Freedom Caucus, unleashing a series of tweets between Saturday and Thursday blaming the group for standing in the way of the AHCA.

    On Thursday, Trump tweeted a broadside at the Freedom Caucus, suggesting he would target them in their reelection efforts.

    "The Freedom Caucus will hurt the entire Republican agenda if they don't get on the team, & fast. We must fight them, & Dems, in 2018!" Trump tweeted.

    Rep. Justin Amash of Michigan, a Freedom Caucus member and opponent of the AHCA who once called it "Obamacare 2.0," struck back at the president on Twitter.

    "It didn't take long for the swamp to drain @realDonaldTrump. No shame, Mr. President. Almost everyone succumbs to the D.C. Establishment,"Amash wrote.

    Rep. Raul Labrador of Idaho, another member of the Freedom Caucus, also replied to the president on Twitter.

    "Freedom Caucus stood with u when others ran,"Labrador tweeted."Remember who your real friends are. We're trying to help u succeed."

    The White House has been engaged, however, in some new discussions on healthcare. Both Vice President Mike Pence and White House chief strategist Steve Bannon have been working behind the scenes to bring the two House GOP sides together on a passable version of the AHCA, according to reports.

    But even with the continued negotiations the task for Republican leaders looks daunting: bring together disparate factions of the House and Senate after a week that only seemed to sew their divisions deeper.

    SEE ALSO: Fox News' Eric Bolling just inadvertently gave a dynamite endorsement of the Obama presidency

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    donald trump

    Donald Trump attacked the media and the Affordable Care Act in a pair of tweets posted Saturday afternoon. 

    "The failing @nytimes finally gets it - 'In places where no insurance company offers plans, there will be no way for ObamaCare customers to ... use subsidies to buy health plans.' In other words, Ocare is dead. Good things will happen, however, either with Republicans or Dems," the president tweeted

    Trump was referring to a New York Times story from Friday

    The president has railed against Obamacare and the ultra-conservative House Freedom Caucus ever since the failure of the American Health Care Act, his first major legislative push for healthcare reform. The bill was pulled from the floor of the House when it became clear it would not have enough votes to pass, and months after Trump promised he would repeal and replace Obamacare "within days" of assuming office.  

    The Freedom Caucus – which was largely responsible for sinking the AHCA – has borne the brunt of Trump's anger, with the president calling it bad for the Republican agenda and threatening to back challengers to the Freedom Caucus in primary elections. 

    Moreover, contrary to the president's claims that Obamacare is "dead" and will implode, analysis by the Brookings Institution showed Obamacare did not qualify under the technical definition of a "death spiral" after the 2016-2017 open enrollment period.

    SEE ALSO: Trump blasts the media and Russia investigation in early morning tweets

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    White House social media director Dan Scavino Jr. took to Twitter on Saturday to urge primary challengers to unseat a prominent member of the hardline conservative House Freedom Caucus.

    Scavino, who has long been a top aide to President Donald Trump, called Michigan Rep. Justin Amash a "big liability" and called for Trump supporters to vote him out in 2018. 

    Amash replied shorty afterward, tweeting: "Bring it on. I’ll always stand up for liberty, the Constitution & Americans of every background."

    "Trump admin & Establishment have merged into #Trumpstablishment. Same old agenda: Attack conservatives, libertarians & independent thinkers," he wrote.

    Scavino's tweet prompted speculation over whether he had violated the Hatch Act, which prohibits executive branch employees from certain political activities.

    "Look at the official photo on this page. Read the Hatch Act and fire this man NOW," tweeted Richard Painter, a former ethics lawyer in the George W. Bush administration.

    Scavino's tweet is the latest move in what appears to be an escalating feud between the Freedom Caucus and the Trump administration, following the failure to repeal Obamacare last month.

    Trump has pinned blame on the group for the failed American Health Care Act, which was pulled just before it went to the House floor after it became clear Republicans were unable to garner enough votes. Members of the Freedom Caucus had argued the bill didn’t go far enough in repealing Obamacare.

    The Freedom Caucus "was able to snatch defeat from the jaws of victory," Trump tweeted earlier this week. "The Freedom Caucus will hurt the entire Republican agenda if they don’t get on the team, & fast."

    Yet members have been defiant in the face of Trump’s criticism. On Thursday Amash tweeted that “It didn’t take long for the swamp to drain @realDonaldTrump.”

    “No shame, Mr. President," he wrote. "Almost everyone succumbs to the D.C. Establishment."

    SEE ALSO: Trump's attacks on the House Freedom Caucus force his supporters in conservative media into awkward position

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    donald trump

    President Donald Trump suggested in an interview published Sunday that he was not done with his attempt to overhaul the US healthcare system, despite the failure of his first attempt.

    In an interview with the Financial Times, Trump said negotiations to repeal and replace Obamacare, the healthcare law officially known as the Affordable Care Act, remained ongoing — and that he would work with Democrats if conservatives could not agree to a deal.

    Trump said that the decision to pull Republicans' new healthcare bill, the American Health Care Act, shortly before a planned vote was up to him and that it did not mean that a healthcare overhaul was dead.

    "But that wasn’t a definitive day. They are negotiating as we speak," Trump told the FT.

    "I don't know if you know. They are negotiating right now. There was no reason to take a vote. I said, 'Don't take a vote,' and we will see what happens. But one way or the other, I promised the people great healthcare. We are going to have great healthcare in this country."

    The bill was pulled after many members of the hardline conservative House Freedom Caucus opposed the bill, leaving the AHCA short of the votes needed to pass the House despite the GOP's majority. Trump has since expressed a possible desire to work with more moderate members of the Democratic caucus.

    Freedom Caucus members have expressed a desire to work out the kinks on healthcare, but Trump has repeatedly attacked the group on Twitter in recent days.

    From the interview (emphasis added):

    "Well I will get the Democrats if I go the second way. The second way, which I hate to see, then the Freedom Caucus loses so big and I hate to see that, because ... our plan is going to be a very good plan. When I say our plan, not phase one just: phase one, two and three added up is a great plan. ... If we don’t get what we want, we will make a deal with the Democrats and we will have in my opinion not as good a form of healthcare, but we are going to have a very good form of healthcare and it will be a bipartisan form of healthcare."

    House Speaker Paul Ryan told CBS in an interview Thursday that he wanted to get the Freedom Caucus on board with the AHCA, worrying that Trump would otherwise "just go work with Democrats to try and change Obamacare."

    According to reports last week, Vice President Mike Pence and White House chief strategist Steve Bannon have been working behind the scenes to win over members of the Freedom Caucus.

    SEE ALSO: The future of 'Trumpcare' is already starting to look like a mess

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    Republican Governor Sam Brownback of Kansas, speaks during the Conservative Political Action Conference (CPAC) in National Harbor, Maryland, U.S., February 23, 2017.      REUTERS/Joshua Roberts Kansas lawmakers on Monday failed to override Republican Gov. Sam Brownback's veto of a bill that would have expanded Medicaid under the Affordable Care Act.

    The Kansas House voted 81-44 to override Brownback's veto, three votes short of the necessary majority needed.

    Brownback vetoed a bill last week that proposed expanding Medicaid, the government-run health program that provides insurance primarily to pregnant women, single parents, people with disabilities, and seniors with low incomes.

    "I am vetoing this expansion of Obamacare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs," Brownback said in a statement.

    Lawmakers have been trying to expand the program under a provision of the Affordable Care Act that opens eligibility up to any adult living under 138% of the federal poverty level — an income of $27,821 for a family of three in 2016.

    Thirty-two states, including the District of Columbia, have chosen to participate, leading to more than 11 million people nationwide gaining coverage.

    The Kansas House passed the bill in February by the same margin of 81-44, and the Senate passed it on Tuesday by a margin of 25-14.

    In the lead-up to the vote on the veto override, many of the bill's supporters acknowledged the tall order.

    Sen. John Doll, a moderate Republican elected in 2016 amidst a public backlash against Brownback's conservative policies, told Business Insider on Thursday that garnering the two votes needed to override in the Senate would be "really difficult."

    "I hope we are able to. I just don’t see it," Doll said.

    Barbara Bollier, a first-term senator representing several Kansas City suburbs and a retired physician, expressed hope that overwhelming public support for the bill could push some senators and representatives from no to yes.

    A public opinion poll conducted by the American Cancer Society in January found that 82% of Kansans support the Medicaid expansion. Several other polls from recent months put the number closer to 62%. Still, it has been hampered, its supporters say, by its association with the Affordable Care Act.

    A major supporter of the bill, Doll said that even if an override failed, public support would ensure that Medicaid expansion will be raised by lawmakers again, though probably not until the next legislative session.

    "It will come before the legislature again and again until it becomes law. Or until [the ACA] is repealed in Washington," Doll said.

    A major obstacle to the bill's passage is its association with the ACA, according to Doll.

    "Some of us can’t get past the origination of the law," Doll said. "We’ve got to look past parties and look at policies. We need a big lesson that at every level of government, but especially state and federal. We need to look at what’s good for the people."

    In his veto memo, Brownback said that an increase in federal Medicaid funding would result in increased funding to abortion providers such as Planned Parenthood and said that because Kansas is "pro-life," he could not support the bill.

    Bollier called Brownback's reasoning "disingenuous" and a "weak excuse," saying that amendments to the Medicaid expansion bill addressing funding to abortion providers were introduced in both chambers and were voted down because voters did not support the measures.

    "The people have spoken. [Planned Parenthood is] not their issue," said Bollier. "We're a far cry from listening to the people right now."

    Bollier also suggested that Brownback's objection to the bill's lack of work requirements for Medicaid recipients was a nonissue because the population gaining coverage is "the working poor."

    SEE ALSO: Check out our deep dive into the battle over the bill in Kansas here

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    Paul Ryan

    WASHINGTON — White House officials made a new offer to conservative House Republicans late Monday on the GOP's failed healthcare bill, hoping to resuscitate a measure that crashed spectacularly less than two weeks ago.

    Vice President Mike Pence and two top White House officials made the offer in a closed-door meeting with members of the House Freedom Caucus, according to a participant. Opposition from the hard-line group, which has about three dozen conservative Republicans, contributed to circumstances that forced House Speaker Paul Ryan to withdraw the bill from a March 24 vote that would have produced a certain defeat.

    Under the White House offer, states would be allowed to apply for waivers from several coverage requirements that President Barack Obama's 2010 healthcare law imposed on insurers.

    These include an Affordable Care Act provision prohibiting insurance companies from declining to write policies for people with serious diseases. Conservatives have argued that such requirements have the effect of inflating insurance costs.

    Freedom Caucus members said they wanted to see the White House offer in writing — which is expected Tuesday — before deciding whether to accept it.

    Also at Monday's meeting were the White House chief of staff, Reince Priebus, and its budget director, Mick Mulvaney. The participant spoke on condition of anonymity to describe the private strategy session.

    Another participant — the Freedom Caucus' chairman, Rep. Mark Meadows of North Carolina — said the group would make no decisions until it reviewed the language, but in a text message he called the session a "good meeting."

    But Meadows also said, "There is no deal in principle" at this time.

    donald trump

    It was unclear whether GOP moderates would accept the proposed changes. When Ryan, a Republican from Wisconsin, pulled the legislation from the House last month, he also faced opposition from moderate GOP lawmakers upset that it went too far with cuts in Medicaid coverage for the poor and higher premiums for many low earners and people in their 50s and 60s.

    Rep. Tom MacArthur, a New Jersey Republican who is a leader of the moderate House Tuesday Group, was among moderate lawmakers who met with officials at the White House on Monday, a GOP aide said.

    The Freedom Caucus has drawn the most wrath from the White House for its opposition to the bill. Some fellow House Republicans have also criticized members of the conservative group, accusing them of inflexibility that led to the downfall of the bill to replace Obamacare, a top GOP legislative priority.

    Six days after the House bill crashed, Trump tweeted that the Freedom Caucus "will hurt the entire Republican agenda" if it didn't start cooperating. He added, "We must fight them" in 2018, a reference to their members' reelection campaigns.

    Several caucus members, who tend to represent safely Republican districts, tweeted back defiantly. But some have stressed a desire to move the legislation along if provisions are added that they believe would contain insurance costs.

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    donald trump

    Just when you thought "Trumpcare" was dead, it appears the American Health Care Act is coming back from the grave. But they will run into a myriad of roadblocks, not the least of which is the legislative calendar.

    New talks have heated up among members of the House GOP conference and the White House, in an attempt to revive the legislation that was pulled from the floor in an embarrassing gambit for Republicans last month.

    According to several reports Monday night and Tuesday, Vice President Mike Pence has been working with members of the hardline conservative House Freedom Caucus to satisfy their demands with a new version of the AHCA.

    But while Republicans will run up against ideological battles — conservatives wanting to totally repeal Obamacare and moderates wanting to preserve certain protections — there is also a practical matter of timing.

    Congress will begin a two-week Easter recess next week, meaning a bill would have to be crafted and brought to the floor before Friday or it would be delayed until after the break.

    Upon returning from the break, lawmakers will have to deal with avoiding a government shutdown before funding runs out on April 28.

    Negotiations over government funding will have to begin shortly after lawmakers return from the break to avoid a shutdown. And the debate over is sure to be contentious and somewhat resemble the initial battle over healthcare, with conservative Republicans fighting moderate Republicans on the size of a funding bill.

    Republicans' other option is to get the AHCA ironed out, moved through the House process and voted on in four days. But House Speaker Paul Ryan said talks were in the "conceptual" stage Tuesday morning.

    And, to add to it all, White House Treasury Secretary Steven Mnuchin has said he wants to have a massive tax reform bill on Trump's desk by the August recess.

    There are 48 legislative days on the calendar before that recess.

    SEE ALSO: The GOP is working on a new healthcare bill

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    House Republicans appear to be stirring up their plans to overhaul the US healthcare system once again after an initial, highly publicized failure last month.

    The American Health Care Act, the GOP plan to repeal and replace Obamacare, has been revisited, with Vice President Mike Pence and White House officials attempting to find a consensus to pass the bill through the House.

    Pence and the White House are trying to win over the conservative House Freedom Caucus, which opposed the original version of the legislation because they felt it did not go far enough in its repeal of Obamacare.

    Reports have indicated that the White House has offered to allow states to repeal two significant elements of the ACA: "community ratings" and so-called essential health benefits.

    While this has the potential to bring the Freedom Caucus on board, it also could cause policy and political problems for the House GOP and President Donald Trump's administration.

    Policy problems

    Here's a quick breakdown of the two important elements that reports suggest the new deal on the AHCA could allow states to repeal:

    • Essential health benefits: These are a baseline of types of care, from prenatal treatment to emergency room visits, that insurers have to cover in their plans. By removing these provisions, insurers could offer plans at a cheaper price, but those plans could cover far fewer types of healthcare needs. Conservatives assert this would increase "choice" for consumers, while opponents say it would leave many people with insufficient coverage.
    • Community rating: In the most basic sense, community rating means insurers can't charge people different premiums except for adjustments based on age and cost-of-living adjustments in different locations.

    By repealing the two rules, people who do get sick could see prices so high for their coverage that it would be virtually impossible for them to afford insurance. While insurers could technically not discriminate based on preexisting conditions, making it incredibly expensive for someone to purchase care would have similar practical effects, as Business insider's Josh Barro wrote.

    Additionally, the list of issues that were considered preexisting conditions before the ACA were incredibly broad, ranging from asthma, to cancer, to eating disorders, to even being employed as a logger or pilot.

    In technical terms, preexisting-condition protections would be left in place. But in practice, these regulations — which are among the most popular parts of the ACA— would be gutted.

    According to reports, the emerging terms of the deal suggest state-level repeals would need to be approved by the federal government.

    Political problems

    The fallout from the proposed tweaks could have political ramifications for Republicans.

    While much of the attention has been paid to the Freedom Caucus in the aftermath the AHCA's original failure, the number of moderate Republicans that came out against the bill was close enough to the threshold for blocking the bill, as well.

    As the House leadership and the White House shifted the bill to make concessions to the Freedom Caucus, more and more of these moderates began to come out against the bill, citing its concerns in going too far in repealing some of Obamacare's more popular provisions.

    "If there is guaranteed access to insurance without community rating, protections for people with pre-existing conditions are illusory," said Larry Levitt, a senior vice president at the nonpartisan Kaiser Family Foundation.

    The undermining of preexisting conditions coverage via the community rating, as well as the changes to essential health benefits, could make the bill politically unpalatable for enough moderate Republicans to block it. In fact, reports suggest that many GOP members are already pushing back on the possible deal with the Freedom Caucus behind the scenes.

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    Promise problems

    Trump has repeatedly said that he wants to keep the preexisting-conditions protections. By potentially undermining these provisions, the new proposed deal could signal a reversal on one of his longest-standing promises on healthcare.

    During an interview with "60 Minutes" following the election, Trump said that the preexisting-conditions aspects of Obamacare "adds cost, but it’s very much something we’re going to try and keep." Trump repeatedly made this assertion on the campaign trail, as well.

    Pence also said in a speech before the election that people with preexisting conditions would not be "charged more or denied coverage," which likely would happen in some states under the new proposals.

    White House press secretary Sean Spicer reiterated the desire to keep coverage affordable for those with preexisting conditions after Trump's speech to the joint session of Congress in late February.

    "First, wanted to make certain that those with preexisting illness and injury were not priced out of the market," said Spicer on March 7. "Nobody ought to lose their coverage because they get a bad diagnosis."

    The bill does not explicitly repeal the parts of the ACA that have to do with preexisting conditions, but the likely effects on prices and coverage for sick people would seem to violate promises from the president.

    SEE ALSO: Republicans are picking a terrible time to roll out 'Trumpcare 2.0'

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